Synovial tissues and pheripheral blood mononuclear cells are obtained from patients with active chronic synovitis, such as rheumatoid arthritis. The analysis of these samples suggests that conditions, such as rheumatoid arthritis, comprise an immunopathologic spectrum. Patients at the polar extremes of this spectrum display consistent phenotypic and functional characteristics. An anergic subpopulation of patients with rheumatoid arthritis has been compared with clinically similar nonanergic group. Peripheral blood mononuclear cells from anergic-patients, in general, exhibited lower T helper/inducer to T suppressor lymphocyte ratios and increased frequencies of HLA-DR bearing T lymphocytes than nonanergic patients. In contrast, synovial tissues from anergic patients, in general, had high intensity T helper/inducer lymphocyte infiltration, while the nonanergic group was, in general, sparsely infiltrated by lymphocytes. Preliminary data also suggest that these phenotypes differences are also reflected by cytokine secretion (e.g., T lymphoctye derived chemotactic factor is produced in abundance by synovium from anergic, but not nonanergic patients). These findings provide insight into pathogenic mechanisms and may result in improved therapeutic procedures.